Hyperhomocysteinemia, low vitamin B12, and low folic acid: Are risk factors of cerebral vascular thrombosis in northwest Iran?

BACKGROUND: Cerebral vascular thrombosis (CVT) is the thrombosis of intracranial and sinuses. The aim of this is to estimate of risk of low folic acid, low vitamin B12, and hyperhomocysteinemia (hyper-Hcys) for CVT. MATERIALS AND METHODS: A total of 24 patients with CVT and 36 healthy controls participated in a cross-sectional case-control study. The deficient levels of folic acid and vitamin B12 defined as <10th percentile of folic acid and vitamin B12 level and hyper-Hcys was defined as >90th percentile of homocysteine of control group. RESULTS: Patients had higher levels of total homocysteine (tHcys) than controls (14.7 ± 6.5 vs. 6.4 ± 2.7 µmol/L, P = 0.001). Also, vitamin B12 level in case group was lower compared to control subjects (185.4 ± 58 vs. 299 ± 75 ng/mL, P = 0.001). Hyper-Hcys and low vitamin B12 were significantly more prevalent in CVT patients than controls. Although, significant independent association with risk of CVT was found for hyper-Hcys [adjusted odds ratio (OR) 14.3, 95% confidence interval (CI): 2.6-77.1, P = 0.002] and low vitamin B12 (adjusted OR 24.6, 95% CI: 2.3-262.9, P = 0.008). Association between low folic acid and risk of CVT was not significant. A significant negative correlation was found between the levels of tHcys and vitamin B12 (r = -0.32, P = 0.01). CONCLUSION: Hyper-Hcys and low vitamin B12 were related with the high risk for CVT.

Study Frequency of Hypertension and Obesity and their Relationship with Lifestyle Factors (Nutritional Habits, Physical Activity, Cigarette Consumption) in Ardabil City Physicians, 2012-13.

BACKGROUND AND OBJECTIVE: Few studies have been done on lifestyle of Iranian physicians. As physicians have important role in health promotion, the main goal of the study was to assess the lifestyle of this influential group. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted on lifestyle of all registered physicians of Ardabil hospitals, Iran, 2012-13. In this research, 225 physicians were selected, by using simple random sampling. Demographic and lifestyle data were obtained by self-report using standard questionnaires, physical activity by official Iranian short-version of the international physical activity questionnaire, and dietary intake by food frequency questionnaire. Weight and height was performed according to standard protocols by using standardized and zero calibrated instruments. Data were analyzed by inferential statistics using Statistical Package for the Social Sciences. 16 software. RESULTS: Findings showed that 8% of participants were hypertensive, 21.3% smoker, 40%-47% inactive, 51.1% overweight, and 18.2% obese. There was a significant relationship between blood pressure and self-reported lifestyle habits (P < 0.05). And 70.7% of males and 74.1% of females had regular 10-min walking each day and moderate activity of males was significantly higher than females (P < 0.05). Food frequency weekly consumption of overweight and obese physicians were significantly higher than normal weight physicians (P < 0.05). CONCLUSION: Few doctors follow a healthy lifestyle; this may have a negative effect on society attitude about health.

Amblyopia Prevention Screening Program in Northwest Iran (Ardabil).

BACKGROUND: The aim of this study was to evaluate the results of amblyopia screening in Ardabil Province in three examination levels by kindergarten teacher, optometrist, and ophthalmologist. METHODS: In a cross-sectional study, the results of the national amblyopic prevention program in 2-6 years old children in Ardabil Province were investigated in 2012. The results pertained to the examinations of children participating in this research were collected in the national approved forms. The data were entered into the computer and were analyzed using statistical methods in SPSS 18. RESULTS: Around 38,844 children (51.7%) out of 75173 with 2-6 years old qualified children participated in the screening program in Ardabil Province. In the first stage of screening, 1068 children (33.1%) are visually impaired in one eye and 2160 children (66.9%) are visually impaired in two eyes. In the second stage, the results related to the examinations by optometrists indicated that the prevalence of refractive errors, strabismus, and others were 70%, 27.8%, and 2.2%, respectively. Refractive errors problem was most prevalent in Ardabil city (72.6%).The prevalence of refractive errors, strabismus, and other reasons in amblyopic children was 51.3%, 23.9%, and 24.8%; respectively. CONCLUSIONS: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

Epidemiology of esophageal cancer in ardabil province during 2003-2011.

BACKGROUND: The aim of this research was to perform an epidemiologic survey of esophageal cancer in Ardabil province. MATERIALS AND METHODS: In this cross-sectional descriptive study, 661 patients diagnosed with EC were studied from March 2002 to May 2011 e. The necessary data were collected with a checklist from the documents in Ardabil Cancer Registry (ACR) and analyzed by statistical methods with SPSS.18 software. RESULTS: Of the total new cases of EC registered in ARC during study period, 430 (65.1%) of patients were male with the male to female standard ratio was 1.18, with a statistically significant gender bias. The most common morphology of EC was squamous cell carcinoma (SCC, 68.8%) followed by adenocarcinoma (28.5%). It was observed that in most of patients, EC lesions were in the middle third of esophagus. In addition, most patients were rural and about 40% had smoking habits. The age-standardized incidence rate of cancers was 48.4 per 100,000 among females and males. The annual incidence rates in males and females was 7.1 and 6.7 per 100,000; respectively. CONCLUSIONS: Results showed that the prevalence and annual incidence rate of cancer in Ardabil province is lower than other areas of the country with a male predominance and a relatively high proprortion of adenocarcinomas.

Analysis of the relationships between esophageal cancer cases and climatic factors using a Geographic Information System (GIS): a case study of Ardabil province in Iran.

Esophageal cancer is a mjaor health problems in many parts of the world. A geographical information system (GIS) allows investigation of the geographical distribution of diseases. The purpose of the present study was to explore the relationship between esophageal cancer and effective climatic factors using GIS. The dispersion distribution and the relationship between environmental factors effective on cancer were measured using Arc GIS. The highest degree of spread was in Germi town and the least was in Ardabil city. There was a significant relationship between effective environmental factors and esophageal cancer in Ardabil province. The results indicated that environmental factors probably are influential in determining the incidence of esophageal cancer. Also, these results can be considered as a window to future comprehensive research on esophageal cancer and related risk factors.

Community based needs assessment in an urban area: a participatory action research project.

BACKGROUND: Community assessment is a core function of public health. In such assessments, a commitment to community participation and empowerment is at the heart of the WHO European Healthy Cities Network, reflecting its origins in health for all and the Ottawa Charter for Health Promotion. This study employs a participation and empowerment plan in order to conduct community assessment. METHODS: The method of participatory action research (PAR) was used. The study was carried out in an area of high socio-economic deprivation in Ardabil, a city in the northwest of Iran, which is currently served by a branch of the Social Development Center (SDC). The steering committee of the project was formed by some university faculty members, health officials and delegates form Farhikhteh non-governmental organization and representatives from twelve blocks or districts of the community. Then, the representatives were trained and then conducted focus groups in their block. The focus group findings informed the development of the questionnaire. About six hundred households were surveyed and study questionnaires were completed either during face-to-face interviews by the research team (in case of illiteracy) or via self-completion. The primary question for the residents was: 'what is the most important health problem in your community? Each health problem identified by the community was weighted based on the frequency it was selected on the survey, and steering committee perception of the problem's seriousness, urgency, solvability, and financial load. RESULTS: The main problems of the area appeared to be the asphalt problem, lack of easy access to medical centers, addiction among relatives and unemployment of youth. High participation rates of community members in the steering committee and survey suggest that the PAR approach was greatly appreciated by the community and that problems identified through this research truly reflect community opinion. CONCLUSIONS: Participatory action research is an effective method for community assessments. However, researchers must rigorously embrace principles of mutual cooperation, respect for public ideas, and a robust belief in community empowerment in order to pave the way for responsible and active citizen participation in the various stages of research.

The Relationship between COPD Assessment Test (CAT) Scores and Severity of Airflow Obstruction in Stable COPD Patients.

BACKGROUND: COPD is a major cause of morbidity in smokers. The COPD assessment test (CAT) is a validated test for evaluation of COPD impact on health status. CAT is not a diagnostic test and pulmonary function test (PFT) still remains the most important diagnostic test. However, its predictive value for evaluation of disease impact is weak. The purpose of this study was to determine the relationship between CAT score and PFT in COPD patients. MATERIALS AND METHODS: We evaluated 105 patients with stable COPD. Demographic data were obtained at baseline. Severity of airflow obstruction was assessed by standard spirometry and classified by the Global initiative for Obstructive Lung Disease (GOLD) criteria. Then, the impact of COPD on health status was assessed using CAT. The CAT scores were categorized into four groups. We statistically compared the relationship between CAT score, COPD stages, CAT groups and PFT. RESULTS: The mean age of patients and mean period of smoking (p/y) were 59.60±11.93SD and 35.43±15.33 SD yrs, respectively. The mean FEV1%predicted was 71.01±26.70SD. The mean CAT score was 19.61±8.07 SD. The correlation between the severity of smoking and GOLD classification was significant (p=0.006). There was a significant association between the FEV1%predicted and total CAT score (r= -0.55, p< 0.001). The correlation between mean FEV1%predicted and mean score of CAT groups 1, 2, 3, and 4 was statistically significant (p<0.001). CONCLUSION: The relationship between CAT score and FEV1%predicted suggests that CAT is linked to severity of airflow limitation and GOLD classification in stable COPD patients. Health status as measured by CAT worsens with severity of airflow limitation.